Autonomy is the rights of patient to make decisions about medical care without their healthcare providers, family members or friends trying to impact their decision or make the decision without making an allowance for them to make their own choice. The main thing that should be done when faced with an ethical dilemma is pinpoint the problem. Although healthcare providers are allowed to educate the patient, the final decision comes from the patient. Even if a patient refuses medical treatment, the decision was made free from pressure or intimidation. There are different but related autonomy problems that take place in healthcare settings. This paper will discuss four different cases all related to decision making and the topics are: medical …show more content…
To put it another way, making decisions for patients can be placed in the hands of the physician and healthcare team. Sometimes health care professionals run into ethical dilemmas where it’s totally left up to them on what to do about a patient because the patient has no family members or friends. However without consent from that patient or at least a guardian the health care team is confronted with not allowing the patient to make their own choices even though they are unable to speak on their own behalf. Consent is not all the time concerned with the living but may consist of asking agreement. Here is a case about a thirty-five year old male who several years before had a pacemaker implanted, but all the way up to know the pacemaker is reaching elective replacement, before anything can be done it is the nurse duty to make sure they patient understand what is going on and consent willingly to the procedure but because the patient is unable to speak on his behalf to say what he would like to be done, Beauregard (2012). For the reason that the patient has no family members or friends the healthcare team has to do what is right on behalf of the patient to avoid patient autonomy related to informed consent. It is not entirely up to the physician or the healthcare team to make that decision on whether to replace the
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Patients have the right to self-determination and individuals should have control over their own lives. With respect for human autonomy comes respect for patient rights. Apart of the nurses job is to promote, advocate and protect the rights, health, and safety of our patients. Patients have the right to determine their health needs, make informed decisions, and the right to information regarding their treatment and also the refusal of treatment. Nurses are obligated to know the rights of a patient and to make sure the patient understands their treatment plan. Supporting patient autonomy includes making decisions in the best interest of the patient, considering their values and recognizing differences between cultures. In the treatment
The two ethical dilemmas that stick out to me in the case are patient autonomy, and distributive justice. Patient autonomy is the patient’s right to make decisions about their care, including whether to accept or decline treatment (Taylor, 2014). Because the patient did not fully understand the information relayed in the consent form or the procedure, her patient autonomy may have been violated. This also may mean the consent form may not be valid. A signed consent form from a patient affords the hospital with an assumed duty to care for that patient (as cited Taylor, 2014). And the patient has given the medical professional permission to provide treatment. Therefore, it is important that the patient fully understands and can communicate that understanding when consenting to
The concept of autonomy in the medical practice brings many different views. Autonomy is the ability individuals have to be self-governing. In these different views there exist two schools of thought, one is the belief that people are born with the ability to do what they want their body and no organization can tell them what to do with their body, like the government. On the other hand, some people believe that it is more complicated and conditional on mental competency so that person can make rational decisions. However, the majority of people seem to advocate for autonomy. A particular largely uncontroversial discussion arises with the case of Dax Cowart, who had his right to autonomy taken from him in a tragic accident and is
Sule stated that, “The Patient Bill of Right adopted by American Hospitals Association states that ‘a patient possesses the right to be informed of the medical consequences of his or her actions and decisions and refuse treatment to the extent permitted by the law’. However, this is true only if the patient is in position to understand the consequences of his treatment. Incompetent, senile patients neither have the correct judgment regarding which treatment is appropriate for them, nor are they in a state of understanding the implications of their treatment. In such case, their willingness to grant or deny consent cannot dictate the course of treatment.” Problem with the Act is being able to find that the patient component enough to make such a call. Another issue that Sule stated was on confidentiality and autonomy. According to Sule, “This is another ethical issue erupting from the conflict of patient's rights and professional ethics in nursing job and profession. The Patient Bill of Right makes it mandatory for the medical practitioners to reveal the form and extent of the ailment along with the course of treatment to be undertaken by the practitioners. However, this law of autonomy clashes with the nursing ethic that the professional should maintain high degree of confidentiality regarding the patient's health and treatment.” This can cause conflicting issues in the NP’s
Autonomy includes three primary conditions: (1) liberty (independence from controlling influences), (2) agency (capacity for intentional action), and (3) understanding (through informed consent) (Beauchamp & Childress, 2009, p. 100). According to Beauchamp & Childress (2009) to respect autonomous agents, one must acknowledge their right to hold views, to make choices, and to take actions based on their personal values and beliefs (p. 103). Respect for autonomy implies thaturges caregivers to respect theassist a patient in achieving? Heed? the autonomous choices of their patients. From there, patients can act intentionally and with full understanding when evaluating medical treatment modalities. Autonomy also includes a set of rules, one of which requires that providers honor patient decision-making rights by providing the truth, also known as veracity (Beauchamp & Childress, 2009, p. 103). In this case, several facets of the principle of respecting autonomy, specifically veracity, informed
The ethics committee has spoken with other healthcare professionals in the community with regards to case. Several professionals feel that there is an ethical dilemma at this time to turn the pacemaker off. The professionals that feel there is a dilemma are Dr. Vijay, Cardiologist; Jane Robinson, Social Worker; and Cindy Mackin, Rehabilitation Center Administrator. The healthcare professionals on the ethics committee understand the issues presented to them and have personally communicated with the patient in regards to her wishes of the patient. Upon investigating other cases involve similar ethical dilemmas, the ethics committee has considered several cases and consultations before reaching a conclusion. (cbhd.org, 2008).
2) If the patient is not legally deemed competent to make his or her own medical decisions then an appointed guardian, next of kin, or power of attorney must provide consent on behalf of the patient, unless it is an emergency situation in which the health care providers must act fast, based on the case of Schloendorff v. Society of New York. In the case of an emergency the medical team may necessary care to keep the patient safe and sustain his or her life.
Manthous states that this deprives the patient of their autonomy. To require informed consent in any and all cases, however, could be difficult. In emotionally charged situations, such as this, it is possible that the will of the patient or their proxies may only create more pain and suffering for the patient in the long run. Manthous mentions this as well, that the decisions of the family of a patient may run contrary to the desires of the patient. While Manthous points out that there are ways for the doctor to then transfer the patient elsewhere, this is a strain on both the doctor himself, and the health-care industry as a
They got her a stable heart rhythm, so she never had a chance to consent to anything. The patient is currently in a state incapacity. There is not preference found or submitted to the hospital stating the patient treatment preferences. The appropriate surrogate to make decisions for the patient is her three adult children. The patient’s kids have the right to make the decision because she doesn’t have a living will or appointed anyone to make medical decision for her. I understand each state has guidelines to follow in a situation like this on who to consult in a situation like this. Some states may follow the same hierarchy plans as Washington State which are included in this order legal guardian, individual with power of attorney for health care decisions, spouse, adult children (all in agreement), parents of patient, and adult sibling (all in agreement). The patient cannot state whether she is unwilling or unable to cooperate with treatment (Clarence H. Braddock III, MD, MPH, 1998).
In the case where the patient is incapable of giving the informed consent and no authorized decision maker is available, the law implies consent on the patient’s behalf. Therefore, if the health administrator in this case decides to administer treatment without informed consent, he/she may be risking their careers and lawsuits against the healthcare. The failure to follow standard of care is also another legal fact that the healthcare administrator should be aware of. In the case that the patient gets injured during treatment, successful claim can be filed against the health care provider.
The right for consent and autonomy of the patient conflicted with the decision of the medical team resulting to an ethical dilemma in this case. An informed consent can be accomplished through communication, implicit or explicit, or a signed consent (Taylor, 2013). The individual must be competent, which means capable of understanding, retaining, using and weighing information to communicate decision with others, in order for the consent to be valid (Taylor, 2013). In addition, the consent should be taken without any medical administration, or distress that can compromise the patient’s competency. The result of an individual or team that committed non-consensual act can be charged with battery, or assault (Taylor, 2013). According to the code of ethics, the health care teams have an obligation to honor the patient’s decision to withdraw (Lachman, 2015). The medical team ignored the withdrawal of the patient concerning the surgery and continues to proceed with the operation, which is a breach from the patient’s consent. If the patient’s rejection is discarded, it also violates the patient’s autonomy, which is the capacity to act freely with decision and independently (Purtilo, 2013). According to the code of ethics, “patients have the moral and legal right to determine what will be done with and to their person,”
Nursing is an all encompassing profession in which practitioners are not only proficient in technical medical functionality, they also have the obligation to remain compassionate and respectful of patients and as such are expected to adhere to pre established codes of ethics. Of these ethics, autonomy is of extreme importance as it offers patients a sense of personal authority during a time where they may feel as if their lives, or at the very least their health, is no longer under their control. Autonomy in the context of nursing allocates the patient and often their family with the final word on the course of treatment. The concept of patient autonomy is a highly variable subject in all fields of health care. It is a universal concept that varies widely in its meaning and interpretation. Autonomy in its simplest form can be defined as a state of independence or self governing (Atkins, 2006). Patient autonomy can also be defined as the ability to make once own decisions, based on one’s sound judgment. It is defined by the American Nurses Association (ANA, 2011) as the "agreement to respect another 's right to self determine a course of action; support of independent decision making." This seemingly straight forward ethical concept is rife with difficulties when one considers potential disagreements that may arise even when informed consent is provided, particularly among children or vulnerable people. Relevant research and
In this particular case study, many ethical principles were violated especially autonomy. Autonomy is defined as “having the freedom to make choices about issues that affect one’s life” (Burkhart and Nathaniel, 2014, pp. 60). Even though the patient is only 17 and not yet classified as an adult Jessica De Bord states
As an administrator I would need to take into consideration the patient’s autonomy, autonomy is recognizing an individual’s right to make his/her own decisions about what is best for them regarding their health care (Pozgar, 2012). The patient’s rights always should be considered before any decisions are made by any other family members. In this scenario it is clear that the patient is unable to make any decisions, the patient has suffered a serious brain damage, and although it is not complete brain death, we must determine how to proceed.
Autonomy applies to the profession of nursing because the patient should always be allowed to make decisions regarding their care while being treated with respect and dignity; however, autonomy can serve as a limiting agent when the patient decides to refuse care that would be of benefit to them. Autonomy is a sensitive issue because it allows the patient to choose to die and all health care can do from that point is allow the patient to do so comfortably. With healthcare always being one step ahead, it allows a surrogate to serve as a voice piece for that patient when they are unable to make decisions. However, that surrogate can end up making decisions they think is best for the patient ignoring the patients’ will. The responsibility of the nurse and interdisciplinary team is to inform and educate the patient and patient’s surrogate on all aspects of care to include medical diagnosis, treatment, and care plan so that the patient and